Abstract

Early detection of cognitive impairment is of paramount importance in clinical settings, with several brief screening tools having been developed for that purpose. The present study sought to evaluate the clinical utility of the Saint Louis University Mental Status examination (SLUMS) at identifying examinees with normal cognition, mild cognitive impairment, or dementia syndrome using the criterion of a comprehensive neuropsychological assessment. Two hundred sixty-three examinees (M age = 67.84 ± 12.72; 59.3% female; 81.4% white) were referred for comprehensive neuropsychological evaluation at a private, Mid-Atlantic medical center. Using original cutoff scores, the SLUMS correctly classified just over half (55.1%) of examinees. Classification statistics suggested modified cutoff scores for mild cognitive impairment (≤24) and dementia (≤17) with strong discriminability between cognitive status groups (AUCs ranged from .834 to .986). These proposed revised cutoff scores improved overall concordance between SLUMS and diagnostic conclusions from comprehensive clinical neuropsychological testing, correctly classifying nearly two-thirds of examinees (65.4%). The SLUMS and its revised cutoff scores appear to have clinical utility for cognitive screening in primary care and neurological settings to inform treatment plans and appropriate referrals for comprehensive neuropsychological assessment.

摘要

认知障碍的早期检测在临床环境中至关重要，为此目的开发了几种简短的筛查工具。本研究旨在评估圣路易斯大学精神状态检查 (SLUMS) 在使用综合神经心理学评估标准识别具有正常认知、轻度认知障碍或痴呆综合征的受试者方面的临床效用。263名考生（M年龄 = 67.84 ± 12.72；59.3% 女性；81.4% 的白人）被转诊到一家位于大西洋中部的私人医疗中心进行全面的神经心理学评估。使用原始截止分数，SLUMS 正确分类了超过一半 (55.1%) 的考生。分类统计表明，轻度认知障碍 (≤24) 和痴呆 (≤17) 的修正截止分数在认知状态组之间具有很强的区分性（AUC 范围从 0.834 到 0.986）。这些提议的修订截止分数提高了 SLUMS 与综合临床神经心理学测试的诊断结论之间的整体一致性，正确分类了近三分之二的受试者 (65.4%)。